Rehabilitation of atrophic jaw using iliac onlay bone graft combined with dental implants
Rehabilitation of atrophic jaw using iliac onlay bone graft combined with dental implants
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DOI：
10.1186/s40729-019-0163-9
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发表时间：
2019-03-19
影响因子：
2.7
通讯作者：
Kim, Soung Min
中科院分区：
文献类型：
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作者：
Truc Thi Hoang Nguyen;Eo, Mi Young;Kim, Soung Min
对种植学家和颌面外科医生来说，修复严重萎缩的牙槽嵴仍然是一个挑战。近年来，在治疗上颌和下颌骨严重骨萎缩的病例中，采用了植牙和隆牙相结合的方法。在自体骨移植中，髂骨移植（IBG）被认为是安全的，可以收集大量的骨和获得高密度的多能细胞。然而，垂直骨吸收可能发生在IBG后的初始愈合阶段。本研究的目的是评估骨移植的成功率和种植体存活率，以及在髂骨上放置牙种植体的增强部位的骨高度和周围的边缘骨水平。我们还介绍了成功的IBG手术的技术和治疗考虑因素，以及最佳的植入物安装策略和软组织操作。方法我们研究了7例在10年内接受IBG联合种植系统治疗的患者。记录骨移植远期成功率和种植体存活率。通过评估增强术后、植入假体时、植入假体时、植入后1年、2年、3年和5年获得的x线片，分析骨高度变化和边缘骨丢失（MBL）。结果平均观察50个月（12 ~ 62个月），IBG成功率为100%。共植入29颗种植体，种植成功率100%。与增强后骨高度相比，3个月后平均骨高度降低1.330.81mm，植入假体时为2.00 +/- 1.88mm，植入假体时为2.55 +/- 1.68mm，植入假体1年后为3.05 +/- 1.63mm。种植体安装后5年累计骨高度变化为4.05±1.83mm，平均吸收率为42.5%。安装后3个月、假体装载时、安装后1年、2年、3年和5年随访时的平均MBL均显著高于安装假体时。然而，安装后2年、3年和5年的MBL差异无统计学意义(p
BackgroundRehabilitating severely atrophic alveolar crests remains challenging for implantologists and maxillofacial surgeons. Recently, a combination of augmentation and dental implantation has been used to treat cases with severe bone atrophy in the maxilla and mandible. Among autogenous bone grafts, iliac bone grafting (IBG) is considered safe for collecting large amounts of bone and obtaining high-density multipotent cells. However, vertical bone resorption may occur during the initial healing stage after IBG. The purpose of the present study is to evaluate bone graft success and implant survival rate, along with bone height in the augmented site and marginal bone level around dental implants placed in iliac onlay bone grafts. We also introduce technique and treatment considerations for successful IBG procedures, as well as optimal implant installation strategy and soft tissue manipulation.MethodsWe examined seven patients who were treated with IBG combined with implant systems over a period of 10years. The long-term success rate of bone grafts and implant survival rate were recorded. Bone height change and marginal bone loss (MBL) were analyzed by assessing the radiograms acquired after augmentation, at implant installation, prosthetic loading, and after installation 1year, 2years, 3years, and 5years.ResultsIn a mean observation period of 50months (range 12-62months), the success rate of IBG was 100%. A total of 29 implants were installed and the implant success rate was 100%. The mean bone height reductions compared to post-augmentation bone heights were 1.330.81mm after 3months, 2.00 +/- 1.88mm at implant installation, 2.55 +/- 1.68mm at prosthetic loading, and 3.05 +/- 1.63mm after implant installation 1year. The cumulative bone height change after implant installation 5years was 4.05 +/- 1.83mm which corresponds to a mean resorption rate of 42.5%. The mean MBL after installation 3months, at prosthetic loading, and after installation 1year, 2years, 3years, and 5years follow-ups were significantly higher than at implant installation. However, MBL at 2years, 3years, and 5years post-installation did not differ significantly (p